Cmet-34. Comparing Stereotactic Radiosurgery With Whole Brain Radiation Therapy in the Treatment of Renal Cell Carcinoma Brain Metastases
Year: 2017
Type: conference-abstract
Abstract: The management of brain metastases involves either definitive or post-operative whole brain radiation therapy (WBRT) or stereotactic radiosurgery (SRS). While radiation improves intracranial control, it is unclear whether this response is dependent on tumor type. We therefore performed a single institution, retrospective analysis of 52 patients with Stage IV renal cell carcinoma (RCC) with metastatic brain lesions who were treated with either WBRT or SRS between 1995 and 2016. Overall survival was defined as time from completion of radiation therapy until death of any cause. Univariate analysis was performed using the Kaplan Meier method, and differences between the groups was assessed with the log-rank test. The median age was 59 and 52.5 in the WBRT and SRS groups, respectively. The median RPA for both groups was 2. For both WBRT and SRS the average number of treated brain lesions was 3. The median dose of WBRT was 3750 cGy while the median dose delivered via SRS was 2100 cGy. The median overall survival of patients receiving SRS was 11.9 months while those receiving WBRT was 15 months (HR 1.14 95% CI 0.58 to 2.23). Progression free survival was 6.23 months and 7.5 months for SRS and WBRT, respectively (HR 1.55, 95% CI 0.78 to 3.05). While intracranial progression was delayed in those treated with WBRT, this difference was not significant (HR 0.56 CI 95% 0.19 to 1.61). 28% of patients who were treated with WBRT ultimately received salvage SRS, and 17% of those who received upfront SRS ultimately received salvage WBRT. From these data, we conclude that both WBRT and SRS remain viable options for the treatment of brain metastases in patients with metastatic renal cell carcinoma. While there was a numerical improvement in median overall survival, progression free survival, and intracranial progression, these findings were not significant.
Source: Neuro-Oncology
Institution: Thomas Jefferson University
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2767321356